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03/12/2015 21: 11 3606714444 PAGE 02102 <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 426-257-8810 - FAX 425-257-8857 -www.everettwa.org <br /> 1728 West Marine View Drive #109 <br /> PROJECT ADDRESS <br /> Owner Mail Address City State/Zip Phone <br /> -Bay-P-%yrAiiatEic-CeateL-172B-lAk,;t Marine View Drove#10.9 Everett VVA )A201 495-9,92-9216 <br /> Tenant Mail Address City State/Zip Phone <br /> I ntercon n act-Systems 1822 Fran [b. Street BellinphgM — WA 918225 360-671-4444 . . <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> S ate License Numb er(required) City of Everett Business License Number(required) <br /> .S1 onn_on _ <br /> Proposed Use of Building Contract Price of Work <br /> --,P-r-vice(d)wnterrnnnp-rtsV,,-rorr <br /> Square Footage(If residential new constructic n, remodel or addition) Contact Person/Contact Numbed5mail <br /> 360-671-4444, option 3 <br /> 10 <br /> Number of devices(If low voltage) <br /> Description of Work to Be Done: <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CO E IS 3105 6006 <br /> 1 hereby certify that I have read and examine this application and know the same to be true and <br /> / <br /> correct. All provisions of laws and ordinances governing this type of work will be completed <br /> whether specified herein or not. The granting of a permit does not presume to give authority to PERMIT# <br /> violate or cancel the provisions of any other state or local law regulating construction or the <br /> performance of construction. That IBM autho 'zed by the owner of this property to perforrn the E 6(oV <br /> work for which application is made and/corn ly with the State Contractors Law 18.27 RCW and <br /> 298.200 WAC. <br /> G gnatu Date <br /> REVISED 0&0612014 <br />